WO2010026458A1 - Drain thoracique - Google Patents

Drain thoracique Download PDF

Info

Publication number
WO2010026458A1
WO2010026458A1 PCT/IB2009/006669 IB2009006669W WO2010026458A1 WO 2010026458 A1 WO2010026458 A1 WO 2010026458A1 IB 2009006669 W IB2009006669 W IB 2009006669W WO 2010026458 A1 WO2010026458 A1 WO 2010026458A1
Authority
WO
WIPO (PCT)
Prior art keywords
chest drain
outlet
inlet
collection chamber
chamber
Prior art date
Application number
PCT/IB2009/006669
Other languages
English (en)
Inventor
Dirk Christiaan De Villiers
Nicolaas Hendrik Smit
Original Assignee
Dirk Christiaan De Villiers
Nicolaas Hendrik Smit
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dirk Christiaan De Villiers, Nicolaas Hendrik Smit filed Critical Dirk Christiaan De Villiers
Publication of WO2010026458A1 publication Critical patent/WO2010026458A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/60—Containers for suction drainage, adapted to be used with an external suction source
    • A61M1/63—Containers for suction drainage, adapted to be used with an external suction source with means for emptying the suction container, e.g. by interrupting suction
    • A61M1/631—Emptying the suction container without interrupting suction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/73—Suction drainage systems comprising sensors or indicators for physical values
    • A61M1/732—Visual indicating means for vacuum pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/80—Suction pumps
    • A61M1/82—Membrane pumps, e.g. bulbs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/101—Pleural cavity

Definitions

  • This invention relates to a chest drain for draining fluids from the thoracic space within which the lungs and heart are retained.
  • the invention relates to a chest drain used to drain fluids from the space around the heart, around the lungs and from in between the lungs.
  • the breathing process is dependent on the existence of a partial vacuum in the pleural space within the chest cavity so that the lungs can expand and contract with the chest cavity when air at atmospheric pressure fills the lungs.
  • This partial vacuum can be disturbed consequent on disease or following surgery or injury and pneumothorax (presence of air) or haemothorax (presence of blood) may develop in the pleural space (potential space around the lungs).
  • pneumothorax presence of air
  • haemothorax presence of blood
  • gases and liquids need to be removed so that the partial vacuum can be restored and normal breathing resumed.
  • excessive blood / exudates are drained from the mediastinum (space between the lungs) and pericardial space (potential space around the heart) after thoracic and cardio thoracic surgery.
  • Such fluid removal is typically carried out by inserting a thoracic catheter into the affected space and connecting the catheter to a chest drain.
  • One of the oldest chest drains is the underwater drain comprising a simple bottle into which a rigid tube is inserted through a cap.
  • the rigid tube is connected by way of a flexible tube, to a catheter inserted into the pleural
  • the rigid tube has its lower end immersed in water or saline solution to a depth that can normally be varied and is typically about 2 cm.
  • the bottle must be kept upright at all times. This, in effect, creates a one way valve which prevents air from flowing back to the chest cavity.
  • a vent tube also passes through the cap of the bottle and may either be open to atmosphere or be connected to low-pressure suction.
  • a major disadvantage of the underwater drain is, however, that the pressure exerted on the pleural space will vary with the depth of water in the bottle as liquids accumulate in it unless the inlet tube is constantly moved upwards to compensate for drained liquids entering the bottle. Also, the system is bulky and thus not very mobile; it ceases to function if overturned; and it normally requires a long flexible tube to connect the bottle to the catheter or chest tube. A long connecting tube is subject to forming kinks that could trap liquids and cause an increase in the pressure required to discharge fluids and or air from the chest cavity.
  • a more recent system that addresses some of the problems associated with the underwater drain is the three-bottle system in which a first bottle serves as a collection facility; a second bottle with an underwater inlet tube serves as the one-way valve; and a third bottle serves as a vacuum control bottle.
  • the major advantages of this system are that the suction pressure can be controlled accurately and the opening pressure of the one-way valve remains constant.
  • a one way flutter valve also called the Heimlich valve
  • the tubing collapses on itself at rest, but when positive pressure is applied to the device from the chest the tubing opens and air escapes. During inspiration, the tubing closes again, creating an effective one-way valve through which air can leave the chest but not re-enter.
  • the major advantage of the Heimlich valve is that it allows greater mobility to the patient.
  • the Heimlich valve on its own cannot be used where significant liquid drainage is expected and it cannot give an indication as to what the pleural pressure is at any time.
  • Another system uses a one-way valve similar to the Heimlich valve, but also has a flexible fluid collection bag. Whilst affording a patient greater mobility and allowing for significant fluid collection, low-pressure suction cannot be applied and in some devices the bag has to be replaced when full.
  • Various other mobile chest drainage solutions have also been developed, some having the function of detecting if air was currently exiting through the device. Air leaks have been detected using a small amount of water in a manometer type of arrangement in which bubbles indicate that air is exiting the device. Some devices also provide a pressure indicator that indicates when the pleural space pressure is larger or smaller than a set value in an attempt to verify that the fluid connection between the device and the pleural space is not blocked.
  • PI 886PC00SinapiChestDra ⁇ n amounts of fluids can be collected in most of them before they need to be emptied.
  • the emptying of some of these devices involves coupling a syringe to the device, without air going into the device during this procedure, and then extracting the liquids, and removing the syringe, again without air entering the device.
  • the fluid filled syringe can be disposed of separately.
  • a chest drain comprising a liquid collection chamber having an inlet for connection to a chest drain tube and a vent outlet for operative venting to atmosphere or for connection to a source of vacuum, and a one-way valve for preventing backflow of fluids from the liquid collection chamber by way of the inlet, the chest drain being characterised in that the inlet has connected to it a variable volume elastomeric bulb in communication with the interior of the inlet and any tube supplying same.
  • elastomeric bulb to be connected in line with the inlet and tube supplying same, and for the elastomeric bulb to be selected such that it can be maintained in a collapsed condition by a vacuum of about 20 cm of water.
  • the chest drain has an outlet chamber located within the liquid collection chamber and interposed between the collection chamber and vent
  • the U-shaped duct may be formed by a dividing wall within the outlet chamber wherein the dividing wall is perforated to allow controlled escape of gases through the outlet chamber without expulsion of the liquid in the U- shaped duct.
  • the communication passage may comprise a larger and a coaxial smaller diameter transverse tube arranged to inhibit any liquid in the collection chamber from entering the outlet chamber irrespective of the orientation of the collection chamber.
  • a baffle is preferably installed between the U-shaped duct and vent outlet from the outlet chamber.
  • the collection chamber will have a drainage outlet typically controlled by way of a manually operable valve that preferably has an air inlet facility to allow for air to enter the collection chamber to replace liquid being drained from it.
  • Figure 1 is a perspective view of one embodiment of chest drain according to the invention from one side thereof with the
  • Figure 2 is the same perspective view of the chest drain from the other lateral side thereof;
  • Figure 3 is a schematic front view of the chest drain
  • Figure 4 is a sectional view taken along line IV-IV in Figure 3;
  • Figure 5 is a sectional view taken along line V-V in Figure 3.
  • Figure 6 is a sectional view taken along line Vl-Vl in Figure 3.
  • a chest drain is made of colourless transparent plastics mouldings and comprises a liquid collection chamber (1 ) of generally rectangular shape and having an inlet (2) at one side of what would generally be the top thereof for connection to a chest drain tube (3) which constitutes the tube supplying the inlet.
  • This connection is effected by way of a variable volume elastomeric bulb (4) that is connected in line with the inlet and chest drain tube so that it is in communication with the interior of both the inlet and chest drain tube. Further detail of the elastomeric bulb will become apparent from what follows.
  • the chest drain tube would, in use, typically enter the pleural space of a patient and terminate in a catheter (5).
  • An appreciably smaller outlet chamber (6) is formed centrally on one major wall (7) of the collection chamber and a transverse communication passage (8) is formed at the top thereof to communicate between the interior of the
  • That communication passage is formed, as shown in Figure 5, between a larger diameter tube (9) closed at one end (10) that is fixed to the wall of the collection chamber opposite that (7) supporting the outlet chamber and terminating short of the latter wall so as to be open at that end.
  • a smaller diameter coaxial tube (11) is open at its end (12) corresponding to the closed end of the larger diameter tube and, at its other end, it extends transversely downwards into the interior of the outlet chamber. It will be understood that such a communication passage will substantially prevent any liquid from entering the outlet chamber as either one or other open end of the larger or smaller diameter tube would generally be above the liquid level.
  • the outlet chamber is divided vertically into two sub chambers by a dividing wall (13) with the smaller diameter coaxial tube (1 1) communicating with the sub chamber on one side of the dividing wall and a vent outlet (14) for operative venting to atmosphere or for connection to a source of vacuum communicating with the sub chamber on the other side of the dividing wall.
  • the dividing wall terminates short of the bottom of the outlet chamber so as to form a communicating slot (15) between the two sub chambers at the bottom.
  • the wall of the sub chamber associated with the communications passage is roughly parallel to the dividing wall over its lower region. This provides a passageway (16) of approximately constant width at such lower region. Spaced upwardly from the lower edge of the dividing wall are two vertically spaced apertures (17) that allow gas to pass towards the vent outlet and create a pressure differential between the two sub chambers.
  • the U- shaped duct formation and that includes the passageway (16) is adapted to retain a liquid in the manner of a manometer formed by a predetermined quantity of water indicated by waterline (18) (see Figure 3) introduced into the outlet chamber for the purpose to thereby indicate the pressure differential.
  • An inclined baffle (19) is installed in the sub chamber associated
  • an elastomeric one-way valve is provided for preventing backflow of fluids from the liquid collection chamber by way of the inlet and back into the elastomeric bulb and chest drain tube.
  • This one-way valve may be a duckbill style of one-way valve that requires about 20 mm of water pressure in order to open it and it can be associated with the inner end of the inlet to the collection chamber, a valve in such a position being indicated by numeral (20).
  • the one-way valve could be attached to the end of the smaller diameter tube of the communication passage so that it is located within the first sub chamber of the outlet chamber and a valve is indicated in that position by numeral (21).
  • a valve located at the inlet to the collection chamber would react more quickly whilst a valve in the outlet chamber is maintained in a cleaner state.
  • the collection chamber has a drainage outlet typically controlled by way of a manually operable valve (22) and such a valve preferably has an air inlet facility to allow for air to enter the collection chamber to replace liquid being drained from it.
  • fluid may flow from the patient and enter the collection chamber through the one-way valve (20) that preferably has an opening pressure of about 20mm of water when its internal surfaces are wetted.
  • the one-way valve (20) that preferably has an opening pressure of about 20mm of water when its internal surfaces are wetted.
  • air is driven through the communication passage to the first sub chamber of the outlet chamber. This air passes through the apertures (17) in the dividing wall and in so doing creates a pressure
  • Draining of the collection chamber can be achieved by disconnecting or clamping any vacuum tube and opening the manually operable valve (22) to allow the contents to drain into a disposal facility.
  • an alternative method to quickly determine whether an air leak is present is to simply depress the bulb and see if or how long it takes to pop out again.
  • the bulb may also be used to create a vacuum / suction by pinching the chest drain tube above it, depressing the bulb, releasing the bulb and releasing the pinch. These steps can be repeated. This procedure is useful to generate a negative pressure when a patient is walking around and is thus not connected to a suction point. It may also be used to suck out possible blockages in the chest drain tube itself.
  • An additional function of the bulb is to reliably indicate whether there is in fact negative pressure in the catheter side of the device.
  • An expanded bulb will serve as a warning to medical staff that there is either very little suction applied or the pressure is already positive.
  • the collection chamber being either totally transparent or at least having a transparent panel can be graduated with volume indicating marks on it.
  • volume indicating marks For measuring smaller quantities of liquid one corner of the generally rectangular collection chamber may be provided with volume indicating marks extending at a 45 degree angle to the horizontal to provides a user with a facility to tilt the device by 45 degrees from vertical so that the liquid runs into the corner.
  • the chest drain could also be provided with a high negativity vent to ensure that a patient is never subjected to excessively high negative pressures.
  • a spring loaded diaphragm is considered to be suitable for the purpose.
  • the chest drain could also be provided with a positive pressure release valve to ensure that a patient is never subjected to high positive pressures. Positive pressures may result if the air vent tube is occluded, the wall suction fails or the valve blocks.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention porte sur un drain thoracique du type qui comporte une chambre de récupération de liquide (1) ayant une entrée (2) destinée à être raccordée à un tuyau de drain thoracique (3) et une sortie d'air (14) pour un échappement à l’atmosphère en fonctionnement ou pour être  raccordé à une source de vide. Une soupape de non-retour (20, 21) est fournie pour empêcher le retour de fluides depuis la chambre de récupération de liquide par l’intermédiaire de l'entrée. L'entrée vers le drain thoracique présente, reliée à celle-ci, une ampoule en élastomère à volume variable (4) en communication avec l'intérieur de l'entrée et un tube quelconque l'alimentant. De préférence, l'ampoule en élastomère est reliée en ligne avec l'entrée et le tube l'alimentant. L'ampoule en élastomère est de préférence choisie de telle sorte qu'elle peut être maintenue dans un état replié par un vide d'environ 20 cm d'eau.
PCT/IB2009/006669 2008-09-04 2009-08-28 Drain thoracique WO2010026458A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ZA200807637 2008-09-04
ZA2008/07637 2008-09-04

Publications (1)

Publication Number Publication Date
WO2010026458A1 true WO2010026458A1 (fr) 2010-03-11

Family

ID=41796782

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2009/006669 WO2010026458A1 (fr) 2008-09-04 2009-08-28 Drain thoracique

Country Status (1)

Country Link
WO (1) WO2010026458A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN103495214A (zh) * 2013-10-21 2014-01-08 湖州市妇幼保健院 一种精确型引流液储存袋
US8882678B2 (en) 2009-03-13 2014-11-11 Atrium Medical Corporation Pleural drainage system and method of use
CN108451313A (zh) * 2018-03-29 2018-08-28 中山市高远精密模具有限公司 一种茶盘排水器
US11577065B1 (en) 2022-04-29 2023-02-14 Pleural Dynamics, Inc. Fluid-management system and method
US11707614B1 (en) 2022-04-29 2023-07-25 Pleural Dynamics, Inc. Fluid-management system and method

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003194A1 (fr) * 1988-09-22 1990-04-05 Francis Emanuel Arnstein Aspirateur manuel portatif, utile tout particulierement dans le domaine medical

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1990003194A1 (fr) * 1988-09-22 1990-04-05 Francis Emanuel Arnstein Aspirateur manuel portatif, utile tout particulierement dans le domaine medical

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8882678B2 (en) 2009-03-13 2014-11-11 Atrium Medical Corporation Pleural drainage system and method of use
US8992493B2 (en) 2009-03-13 2015-03-31 Atrium Medical Corporation Chest drainage systems and methods
US9314599B2 (en) 2009-03-13 2016-04-19 Atrium Medical Corporation Pleural drainage system and method of use
US9814807B2 (en) 2009-03-13 2017-11-14 Atrium Medical Corporation Chest drainage systems and methods
US10933175B2 (en) 2009-03-13 2021-03-02 Atrium Medical Corporation Chest drainage systems and methods
US11896755B2 (en) 2009-03-13 2024-02-13 Atrium Medical Corporation Chest drainage systems and methods
CN103495214A (zh) * 2013-10-21 2014-01-08 湖州市妇幼保健院 一种精确型引流液储存袋
CN108451313A (zh) * 2018-03-29 2018-08-28 中山市高远精密模具有限公司 一种茶盘排水器
CN108451313B (zh) * 2018-03-29 2023-09-22 中山市高远精密模具有限公司 一种茶盘排水器
US11577065B1 (en) 2022-04-29 2023-02-14 Pleural Dynamics, Inc. Fluid-management system and method
US11707614B1 (en) 2022-04-29 2023-07-25 Pleural Dynamics, Inc. Fluid-management system and method
US11779741B1 (en) 2022-04-29 2023-10-10 Pleural Dynamics, Inc. Fluid-management system and method

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